Health Care Utilization in Homeless People: Translating Research into Policy and Practice

Product type:

Working Paper 10002

MEPS component:

Household Component

Publication date:

October 12, 2010

Description:

This research study describes and summarizes the background, objectives, methods, research findings and implications for policy and practice from an AHRQ grant entitled "Health Care Utilization in Homeless People" (1 RO1 HS04129-01). The major aims of the study were as follows: 1) to measure all health care utilization (hospitalization, emergency department visits, and ambulatory/office-based care visits) in a representative sample of homeless mothers, single women, and single men, as well as to identify individual characteristics associated with health care utilization; and 2) to test the hypothesis that the use of ambulatory care services by homeless people reduces the likelihood of emergency department utilization. The study enrolled a random sample of 1,190 homeless individuals in Toronto, Canada in 2004-2005. Sampling was stratified by sex and family status, resulting in the enrollment of 603 single men, 303 single women, and 284 heads of families (plus 421 children in these 284 families). Homeless participants were matched 1:1 to low income controls from the general population based on year of birth and sex. National health care expenses in the U.S. civilian non-institutionalized population were obtained for the following event-level outcomes; hospital inpatient services, emergency room services and office-based medical provider services (restricted to physicians only) for 2006. This study will highlight important new research findings which have substantial policy implications. Knowledge from this research can inform the development of more effective strategies to deliver health care for homeless individuals and families in the U.S. Documenting the burden of illness and the prevalence of diseases and conditions in the homeless population is critical to understanding patterns of primary care utilization and its relationship with utilization of emergency departments.